What is the NPR program?
Heartland Kidney Network’s PatientAdvisory Committee (PAC) developed the Network Patient Representative (NPR) program to help spread educational information
to patients and provide them with additional support by a fellow patient in their dialysis clinic. The Network’s NPR program is made up of NPRs from across Iowa, Kansas, Missouri, and Nebraska.
Heartland Kidney Network
What are the responsibilities of an NPR?
It is really up to the NPR how involved they want to get, but at minimum we ask that NPRs do the following: Share educational materials from the Network and their clinic with
other patients (such as posting info on a bulletin board)
Be available to give support to new and current patients by phone,
email, or in-person
Join the monthly NPR Connection Call the first Tuesday of the month
to receive Network updates and to discuss ideas with other NPRs
Refer patients with questions or concerns to appropriate clinic staff
(avoid giving medical advice)
Who are NPRs?
NPRs are individuals that are on dialysis or have had a kidney transplant. They volunteer at their dialysis clinic working withstaff to help improve the patient experience and share patient education. NPRs can also serve as peer mentors to fellow patients by
sharing their experiences and providing support and encouragement. NPRs are role models in their clinic because of their positive outlook and their desire to learn as much about their kidney disease and treatment as they can to improve their quality of life.
Network Patient
Representative (NPR) Program
Overview
For more information or to file a grievance, please contact the Heartland Kidney Network at: 920 Main Street, Suite 801, Kansas City, MO 64105
Network Patient Representative (NPR) Program Q&A:
1. How do I apply to become an NPR? Talk to your clinic staff about your interest. Then you need to complete the NPR Interest Form and ask a staff member to fill out the Staff Nomination Form. Both forms should be sent together to the Network either by mail or fax.
2. How will I know if I am approved? You will hear from the Network within 2 weeks and will receive an NPR Starter Kit folder sent to your mailing address. 3. What if my clinic already has an NPR, can we have more than one? Yes, there
can be more than one NPR at a clinic, but we advise only one per shift. NPRs at the same clinic can work together to plan activities.
4. What are current NPRs doing to serve at their dialysis clinic? NPRs do all sorts of things at their clinic depending how much time they have. You can get creative but here are some examples:
maintaining the patient bulletin board with announcements, education,
and recipes
working with their social worker to welcome new patients
organizing patient social gatherings and/or outings
writing articles for the clinic’s monthly newsletter
talking with patients that are having a difficult time with dialysis
helping staff plan fun activities at the clinic
sharing ideas with the Network about patient projects and/or resources
Are you interested in joining a group of dedicated patients across the Network to help improve the patient experience at your dialysis clinic?
Become a Network Patient Representative (NPR) TODAY!
For more information or questions, please contact Ellie Vail, NPR Program Coordinator, toll free at
800-444-9965 ext. 709 or
by email at [email protected].
This resource was (created, developed, compiled, etc.) while under contract with Center for Medicare and Medicaid Services, Baltimore, Maryland. Contract HHHSM -500-2013-NW012C. The contents presented do not necessarily reflect CMS policy.
Name:_______________________________ Birthday (month/day):______________ Address:______________________________ Phone:__________________________ City:_________________________________ Email:___________________________ State/Zip:_____________________________
Dialysis clinic or transplant center name:_______________________________________ Facility street address:______________________________________________________ Facility city/state/zip:_______________________________________________________ Nominating staff member name:_____________________________________________ Current treatment type: _________________________ Others:____________________ How long have you been on dialysis?________________________
Help Heartland Kidney Network get to know you and tell us a little about yourself:
________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Why are you interested in becoming an NPR for your dialysis clinic?
________________________________________________________________ _____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________
Please continue to the next page.
Representative (NPR)
Statement of Interest Form
What are you looking forward to doing the most with your new role as NPR?
_________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________
I have read the NPR Program Overview and understand my role as an NPR.
Signature:__________________________________________ Date:__________________ Now that you have completed your portion of the NPR application, you need to ask a staff member at your dialysis clinic or transplant center to fill out the Staff Nomination form. Once you have both forms completed, you may mail the application or ask a staff member to fax it.
Return this Statement of Interest and the Staff Nomination form to:
Heartland Kidney Network Attn: NPR Program 920 Main St. Suite 801 Kansas City, MO 64105
Fax: 816-880-9088
Thank you for your interest in becoming an NPR at your clinic. Network staff will be in contact with you soon. If you have any questions, contact Ellie Vail toll-free at
(800) 444-9965 or email at [email protected].
This resource was (created, developed, compiled, etc.) while under contract with Center for Medicare and Medicaid Services, Baltimore, Maryland. Contract #HHSM-500-2013-NW012C. The contents presented do not necessarily reflect CMS policy.
For more information or to file a grievance, please contact the Heartland Kidney Network at: 920 Main Street, Suite 801, Kansas City, MO 64105
Staff Nomination Form
Patient Info: Recommending Staff Member Contact Info:
Patient Nominee: ________________________________ Address: _______________________________________ City/State/Zip____________________________________ Phone:_________________________________________
*Clinic Medicare Provider Number (CCN):_____________
(this is required to help the Network monitor the spread of the NPR Program among clinics)
Total number of patients at unit:___________________ (this will help if we send resources for distribution)
Name: ______________________________________ Title: _______________________________________ Dialysis Clinic: ________________________________ Address: ____________________________________ City/State/Zip________________________________ Phone: ____________________________________ Email: ______________________________________
Why do you think your patient nominee would make a good Network Patient Representative (NPR) for your clinic?
_________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________
By nominating (insert patient nominee) _____________________________, I agree to encourage their involvement at our clinic and support their efforts to improve the patient experience. I will also be the Network’s staff contact regarding the NPR Program at our clinic.
Signature: ___________________________________________ Date: __________________________
Please return this form with the Patient’s NPR Statement of Interest form to:
Heartland Kidney Network Attn: NPR Program 920 Main St. Suite 801 Kansas City, MO 64105 Fax: 816-880-9088
